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posterior stroke OR cerebellar Stroke OR posterior Infarct

Jonathan Rychen, Davide Croci, Michel Roethlisberger, Erez Nossek, Matthew B Potts, Ivan Radovanovic, Howard A Riina, Luigi Mariani, Raphael Guzman, Daniel W Zumofen
OBJECTIVE: To clarify the reported experience with keyhole approaches for the treatment of intracranial aneurysms. METHODS: The PubMed and Embase databases were searched up to December 2017 for full-text publications that report the treatment of aneurysms with the eyebrow variant of the supraorbital craniotomy (SOC), the minipterional craniotomy, or the eyelid variant of the SOC. The anatomical distribution of aneurysms, the postoperative aneurysm occlusion rate, and the type and rate of complications were examined using univariate analysis...
October 12, 2018: Neurological Research
Dan He, Qian Li, Guangjin Xu, Zheng Hu, Xuefei Li, Yinping Guo, Shabei Xu, Wei Wang, Xiang Luo
INTRODUCTION: Right-to-left shunt (RLS) induced by a patent foramen ovale (PFO) is associated with an increased risk of cryptogenic stroke (CS). However, little is known about the relationship between the amount of RLS and the stroke pattern. In this study, we aimed to evaluate the distinct clinical features of PFO-related CS in different RLS degrees resulting from PFO. METHODS: This is a cohort study of 222 CS patients admitted to the Tongji Hospital from 1st May 2014 to 31st April 2017...
October 11, 2018: Brain and Behavior
Mario Campero, Ricardo Hughes, Patricia Orellana, Jorge A Bevilacqua, Roberto J Guiloff
This paper illustrates the cases of two patients with an acute onset of right brachial neuropathic pain, flaccid paralysis and contralateral thermal and thermal pain hypoesthesia, without posterior column impairment nor pyramidal signs below the segmental lesion. MRI showed right sided spinal cord infarction, in the anterior spinal artery territory between C1 and C5 in one patient and between C3 and C7 in the other. Contact Heat Evoked Potentials and Quantitative Thermal Sensory testing are consistent with contralateral, but not ipsilateral, spinothalamic tract involvement...
October 1, 2018: Journal of the Neurological Sciences
Nooreen Hussain, Faiz Hussain, Abdullah Malik, Muaz Rizvi, Preeti Patel, Subramanyam Chittivelu
The improving life expectancy for CF is known to be one of the biggest success stories in medicine. Life expectancy has increased from 6 months during the early 20th century to 42.7 years from in 2012-2016. As the life expectancy of CF patients has increased, it is important to consider other co-morbidities that these patients may encounter, and the impact this may have on their morbidity and mortality. We present a case of a 33-year-old male admitted to the hospital for a CF exacerbation who had an acute neurological decompensation due to an infarction of his right occipital and posterior temporal lobe...
2018: Respiratory Medicine Case Reports
Hyun Ho Choi, Young Dae Cho, Dong Hyun Yoo, Eung Koo Yeon, Jeongjun Lee, Su Hwan Lee, Hyun-Seung Kang, Won-Sang Cho, Jeong Eun Kim, Moon Hee Han
BACKGROUND: Posterior communicating artery (PcoA) compromise may serve as adjunctive treatment in patients with hypoplastic variants of PcoA who undergo coil embolization of PcoA aneurysms. However, procedural safety and the propensity for later recanalization are still unclear. OBJECTIVE: To evaluate clinical and radiologic outcomes of coil embolization in this setting, focusing on compromise of PcoA. METHODS: As a retrospective review, we examined 250 patients harboring 291 aneurysms of hypoplastic PcoAs, all consecutively treated by coil embolization between January 2004 and June 2016...
October 5, 2018: Journal of Neurointerventional Surgery
András Folyovich, Viktória Varga, György Várallyay, Lajos Kozák, Mária Bakos, Erika Scheidl, Katalin Anna Béres-Molnár, Zita Kajdácsi, Dániel Bereczki
BACKGROUND: Unilateral weakness of an upper extremity is most frequently caused by traumatic nerve injury or compression neuropathy. In rare cases, lesion of the central nervous system may result in syndromes suggesting peripheral nerve damage by the initial examination. Pseudoperipheral hand palsy is the best known of these, most frequently caused by a small lesion in the contralateral motor cortex of the brain. The 'hand knob' area refers to a circumscribed region in the precentral gyrus of the posterior frontal lobe, the lesion of which leads to isolated weakness of the upper extremity mimicking peripheral nerve damage...
October 3, 2018: BMC Cancer
Hidetoshi Matsukawa, Hiroyasu Kamiyama, Takanori Miyazaki, Yu Kinoshita, Nakao Ota, Kosumo Noda, Norihiro Saito, Takaharu Shonai, Osamu Takahashi, Sadahisa Tokuda, Rokuya Tanikawa
The risk associated with surgical treatment for small-to-moderate size unruptured intracranial aneurysms (SMUIAs, defined as <15 mm) has not been well characterized. Authors aimed to investigate risk factors for poor outcome in surgical treatment of SMUIAs. The data of prospectively collected 801 consecutive patients harboring 971 surgically treated SMUIAs was evaluated. Neurological worsening (NW) was defined as an increase in 1 or more modified Rankin Scale at 12-month. Clinical and radiological characteristics were compared...
September 29, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Khushbu Goel, Saraj Kumar Singh, Himanshu Agarwal, Joy Dev Mukherji, Mukesh Kumar
Isolated wrist drop is very unusual clinical presentation due to cerebral stroke. It is highly confused with peripheral neuropathy. However, timely detection of acute stroke as one of the causes of wrist drop is necessary as it changes the line of treatment and prognosis significantly. Here we are presenting a 62 year-old diabetic and hypertensive male patient who came with acute onset weakness of right hand. Initial Magnetic resonance imaging (MRI) of the brain showed hyperacute infarct in the splenium of corpus callosum...
October 2018: Journal of Neurosciences in Rural Practice
Shiori Ogura, Eijirou Tanaka, Shinji Ashida, Keiko Maezono, Yoshinari Nagakane
A 61-year-old man, with a history of right clavicular fracture 35 years prior, visited our hospital due to the sudden onset of vertigo and tinnitus following weakness and numbness in his left arm and leg. He also had a 6-month history of right arm pain with overuse. Brain MRI showed acute brain infarcts in the right posterior cerebral artery territory. Intravenous alteplase was administered 188 minutes after onset. Although heparin infusion was commenced on day 2, he had vertigo again on day 9, and MRI showed a recurrent brain infarct in the right posterior inferior cerebellar artery territory...
September 29, 2018: Rinshō Shinkeigaku, Clinical Neurology
Karen Chen, Elisabeth B Marsh
OBJECTIVE: Post-stroke fatigue (PSF) is a debilitating complication of stroke recovery. Contributing risk factors, whether they are modifiable, and if they change over time remain understudied. We determine factors associated with PSF and how they evolve from the subacute through chronic phases of recovery. PATIENTS AND METHODS: A consecutive series of patients presenting to our comprehensive stroke center with acute stroke were seen in follow-up within 6 months of infarct and administered the Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scale to evaluate for PSF...
September 17, 2018: Clinical Neurology and Neurosurgery
Dong-Eog Kim, Jong-Ho Park, Dawid Schellingerhout, Wi-Sun Ryu, Su-Kyoung Lee, Min Uk Jang, Sang-Wuk Jeong, Jeong-Yong Na, Jung E Park, Eun Ja Lee, Ki-Hyun Cho, Joon-Tae Kim, Beom Joon Kim, Moon-Ku Han, Jun Lee, Jae-Kwan Cha, Dae-Hyun Kim, Soo Joo Lee, Youngchai Ko, Byung-Chul Lee, Kyung-Ho Yu, Mi Sun Oh, Keun-Sik Hong, Yong-Jin Cho, Jong-Moo Park, Kyusik Kang, Tai Hwan Park, Kyung Bok Lee, Kyoung-Jong Park, Heung-Kook Choi, Juneyoung Lee, Hee-Joon Bae
Importance: Cerebral vascular territories are of key clinical importance in patients with stroke, but available maps are highly variable and based on prior studies with small sample sizes. Objective: To update and improve the state of knowledge on the supratentorial vascular supply to the brain by using the natural experiment of large artery infarcts and to map out the variable anatomy of the anterior, middle, and posterior cerebral artery (ACA, MCA, and PCA) territories...
September 24, 2018: JAMA Neurology
Aliaa Ghoneim, Christopher Pollard, John Greene, Ravi Jampana
Balint's syndrome is a rare disorder characterized by a triad of simultanagnosia, optic apraxia, and ocular apraxia. The syndrome manifests when there is an injury to the posterior parietal and occipital lobes and is often bilateral. Several causes of this syndrome were published in the literature, such as trauma, infarctions, infections, tumors, and pre-eclampsia. It can also be the presenting feature of several neurodegenerative disorders, such as atypical Alzheimer's disease. We report a case of a 62-year-old lady who presented with simultanagnosia, optic apraxia, and ocular ataxia which are the typical signs and symptoms of this syndrome...
December 2018: Radiology Case Reports
Rajeswari Aghoram, Sunil K Narayan
Context: Intracranial atherosclerosis is a common cause of stroke in India. Transcranial Doppler (TCD) provides a noninvasive way to study basal intracranial blood vessels. The Oxfordshire Community Stroke Project (OCSP) classification is a simple clinical stroke classification system that has prognostic significance and has been associated with size and location of the infarct. Aim: This study was undertaken to identify patterns of TCD abnormalities in our stroke population particularly in relation to the OCSP classification...
July 2018: Annals of Indian Academy of Neurology
Robert C Rennert, Ben A Strickland, Kristine Ravina, Joshua Bakhsheshian, Joseph Carey, Jonathan J Russin
BACKGROUND: Minimally invasive skull base approaches, including the cosmetically optimal transblepharo-preseptal modified orbitozygomatic (TBMOZ) technique, have been described to treat proximal anterior circulation aneurysms. The use of minimally invasive techniques for previously ruptured aneurysms is rare because of perceived technical challenges in controlling intraoperative ruptures. Herein, we determine the utility of the minimally invasive TBMOZ approach for the treatment of ruptured proximal anterior circulation aneurysms...
October 2018: World Neurosurgery
Ramiro Castro-Apolo, Josephine F Huang, Myrian Vinan-Vega, William O Tatum
PURPOSE: To evaluate clinical, radiographic, and electrophysiological features in the development and prognosis of ischemic post-stroke seizures (PSS). METHOD: A retrospective study of 1119 patient records was performed between January 2006 and December 2016. After selection, 42 patients with seizures due to ischemic stroke were matched to a control group of 60 patients where seizures were absent. Stroke size and severity were analyzed using ASPECTS and NIHSS, respectively...
September 14, 2018: Seizure: the Journal of the British Epilepsy Association
Sang Hun Lee, Keun-Sik Hong, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu, Sun U Kwon
OBJECTIVES: To investigate the predictors of hemorrhagic transformation (HT) in patients with mild atrial fibrillation-related stroke who were treated with early anticoagulation. We conducted a post-hoc subgroup analysis from Acute Cerebral Infarction Patients with Non-valvular Atrial Fibrillation (Triple AXEL) study. PATIENTS AND METHODS: The Triple AXEL study was a randomized, multicenter, open-label, blinded end-point evaluation, comparative phase 2 trial. To identify the relationship between the type of HT and risk factors...
September 9, 2018: Clinical Neurology and Neurosurgery
Krishna Amuluru, James P Ho, Fawaz Al-Mufti, Sten Solander, Charles E Romero
A fetal posterior cerebral artery (FPCA) is an anatomic variant in which the posterior cerebral artery is an embryological derivative of the internal carotid artery. Although most cases of ischemic strokes in patients with FPCAs involve embolic infarcts, emergent large vessel occlusion of a FPCA is extremely rare. We present two cases of successful endovascular intervention for emergent occlusion of a FPCA, one of which is only the second reported case of a mechanical thrombectomy of a FPCA. We review the embryology of FPCA, the controversy regarding its association with cerebral infarcts, and various approaches used in the treatment of such occlusive lesions...
September 19, 2018: Interventional Neuroradiology
Houman Sotoudeh
The recent approach to treat acute stroke is to extend treatment window in patients with salvageable peri-infarct ischemia which increases the application of the perfusion imaging, specifically computed tomography perfusion (CTP). In this paper, I am presenting a case of left middle cerebral artery infarction which was evaluated by CTP under "code stroke." The patient had an incidental spinal canal meningioma which was out of field of view in CTP but mimicked right cerebellar ischemia on CTP. Although ischemia has been previously reported within the peripheral parenchymal edema surrounding a meningioma, in this patient there was no evidence of edema in the right cerebellum on magnetic resonance imaging...
October 2018: Radiology Case Reports
Zeqin Xu, Yongquan Gu, Jianxin Li, Chunmei Wang, Rong Wang, Ying Huang, Jian Zhang
OBJECTIVE: Stroke is the most common neurological disease that is associated with deglutition disorders. The aim of this study was to analyze dysphagia and aspiration pneumonia risk factors in post-stroke elderly inpatients. METHOD: We consecutively enrolled 212 stroke patients over sixty years of age from July 2014 to June 2015. Seventeen patients were eliminated. Stroke patients' demographics, clinical symptoms and biochemistry data were collected. Modified water swallowing test was used for the assessment of deglutition difficulty...
September 6, 2018: Journal of Back and Musculoskeletal Rehabilitation
Christer Sawaya, Raja Sawaya
BACKGROUND A lumbar puncture is a procedure performed to uncover the state of the central nervous system by analysis of the cerebrospinal fluid. It is done also to infuse medications in the subdural space. A lumbar puncture should not cause central nervous system bleeding, but this complication is still occurring in certain cases. CASE REPORT We present 2 cases where a lumbar puncture was performed in the emergency department. The first patient had severe inflammatory lower back pain and received epidural steroids through a lumbar puncture and the second case presented with the clinical picture of meningitis and a lumbar puncture was performed for diagnostic purposes...
September 17, 2018: American Journal of Case Reports
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